significant daily activities. The most prevalent chronic conditions (expressed in terms of morbidity from these conditions) in the elderly population include arthritis, hypertension, hearing impairments, and heart conditions (Table 3.15).

Older women experience chronic conditions (such as arthritis and osteoporosis) more frequently than men, and older men experience acute conditions (such as heart attacks) more often than women. In general, the health situation of elderly blacks is poorer than that of elderly whites.

Activity Limitations

Most elderly people do not need long-term-care assistance, but many suffer from some form of impairment that limits their ability to perform basic activities of daily living (ADLs) (Rowland et al., 1988). A broad set of ADLs includes eating, toileting, dressing, bathing, transferring, going outside, and walking; a “core set” of five ADLs includes all those except walking and going outside. ADLs categorize levels of functional impairment and thus have many health care planning, research, and policy purposes, such as increasing our understanding of the population at risk of institutionalization (or alternatively, in need of long-term-care services).

Functional impairment can be defined in many ways—ranging from difficulty with at least one ADL in the broad set (e.g., difficulty bathing) to

TABLE 3.15 Prevalence per 1,000 Population of Top Ten Chronic Conditions, by Age Group: 1986

Condition

All Ages

Age 45–64

Age 65+

Age 65–74

Age 75+

Arthritis

131

285

480

443

540

Hypertension

123

251

394

385

409

Sinusitis

145

187

169

169

171

Orthopedic impairment

115

162

173

158

196

Hearing impairment

88

136

296

244

378

Heart disease

78

123

277

250

319

Diabetes

28

64

98

92

109

Tinnitus

27

49

85

83

88

Visual impairment

35

46

95

69

136

Cataracts

21

21

141

84

233

 

SOURCE: NCHS, 1987c.



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